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Cimetidine

Systems	Gastro-Intestinal System
Category	H2-receptor antagonist

Pharmacokinetics

It is well absorbed orally (60-80 %), but its bioavailablity is reduced by about 1/3 when given with antacids. Theraupetic effect lasts for about 5-8 hours. It is excreted mainly in the urine, within 24 hours,mainly as unchanged drug. It can cross the placental barrier and is secreted in milk.

Indications

Cimetidine belongs to the class H2-receptor antagonists, known also as H2-blockers, which are used to treat duodenal ulcers and prevent their recurrence. They are also used to treat gastric ulcers and in some conditions such as Zollinger-Ellison syndrome.

Routes of Administration and Dosage

ORAL--[1] Duodenal and gastric ulcers: 800 mgs daily at bed time for 4-8 weeks followed by 400 mgs daily at bedtime. [2] Zollinger ellison syndrome: 400 mgs four times a day. [3] Stress ulcer prevention:200-400 mgs orally every 4-6 hrs. IV-- In pathological hypersecretary conditions and intractable ulcers in hospitalized patients: 200 mgs slow IV injection given over 2 mins, may be repeated 4 to 6 hourly.

Contra Indications

H2-blockers are contraindicated in patients with hypersensitivity.

Precautions

Allergies to Cimetidine can occur. Precaution during Breast-feeding : Cimeitidine passes into the breast milk and may cause adverse effects in the nursing baby. In Adults : Confusion and dizziness may be occur.

Interactions

Aminophylline, Anticoagulants, Caffeine, Metoprolol, Oxtriphylline, Phenytoin, Propranolol, Theophylline, Tricyclic antidepressants (amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, nortriptyline, protriptyline ) : these drugs when used with Cimetidine has been shown to greatly potentiate the effects of Cimetidine.H2-blockers may decrease the effects of itraconazole and ketoconazole, hence H2-blockers should be taken at least 2 hours after these drugs.

Brand Names

Cimetidine-CHC (Cadila Healthcare), Cimetiget (Franco-Indian), Cimetin (PCI), Lock-2 (Cadila Healthcare), Tymidin (SPPL), Ulciban (Torrent)